Carcinoid szindrómával társuló metasztatikus középbél-eredetű neuroendokrin tumor kezelése | Treatment of metastatic midgut neuroendocrine tumour associated with carcinoid syndrome

A neuroendokrin tumorok prevalenciaja lassu korlefolyasuk kovetkezteben, alacsony incidenciajuk ellenere, magas. A szerzők osztalyan 2008. julius 1. es 2013. julius 1. kozott 56 beteget vizsgaltak jol, illetve kozepesen differencialt neuroendokrin tumor miatt; kozuluk 39 attetes daganatos beteget reszesitettek kezelesben, 17 beteg a daganat műteti eltavolitasa utan a kovetesen kivul nem igenyelt kezelest. Az attetes betegek mindegyike tartos hatasu octreotidkezelesben reszesult; a tovabbi terapias lehetősegeket a daganatok kiindulasi helye, differencialtsagi foka, Ki-67-indexe, valamint a szomatosztatinreceptor, illetve metajod-benzil-guanidin szcintigrafia eredmenye szabta meg. A szerzők reszletesen ismertetik egy metasztatikus kozepbel carcinoid tumoros beteguk kortortenetet, akinel tartos hatasu octreotidot es peptidreceptor radionuklid terapiat alkalmaztak. A kezeles a carcinoid szindroma tuneteinek megszűnesen tul objektiv tumorvalaszt is kivaltott. Az eset megerősiti, hogy a tartos hatasu octreotid es peptidreceptor radioterapia metasztatikus kozepbel-eredetű neuroendokrin tumoros betegekben jo eletminőseget es hosszu tulelest biztosithat. Orv. Hetil., 2014, 155(5), 194–198. | Although the incidence of neuroendocrine tumours is low, their prevalence is high due to the usually slow course of the disease. Between July 1, 2008 and July 1, 2013 the authors evaluated 56 patients with well-differentiated or moderately differentiated neuroendocrine tumours; 36 patients with metastatic disease underwent treatment while 17 patients who had tumour resection were followed without additional treatment. All patients with metastatic disease received long acting octreotide, and additional therapy was based on the site of origin, grade of differentiation, Ki67 index, and focal labelling of the tumours during somatostatin-receptor or metaiodo-benzyl-guanidine scintigraphy. The authors present a detailed case history of a patient with carcinoid syndrome due to a metastatic midgut neuroendocrine tumour, who received long acting octreotide and peptide receptor radionuclide treatment. In this patient an objective tumour response was reached in addition to the resolution of symptoms of carcinoid syndrome. The authors conclude that the case history confirms previous observations showing that long acting octreotide combined with peptide receptor radionuclide treatment may provide long survival with good quality of life in a patient with metastatic midgut neuroendocrine tumour accompanied with carcinoid syndrome. Orv. Hetil., 2014, 155(5), 194–198.